Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Plastic mod low ext pad/line
Edina, MN
See all hospitals reporting HCPCS L2275 →Price type
Fairview Health Services’s median price of $176 is 9% above the median hospital's median price ($161), higher than 60% of the 999 hospitals reporting HCPCS L2275. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 33 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Bcbs Mn pmap fee schedule · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 2 | Bcbs Mn aware federal fee schedule · both | $146 | $146 | — | — | — | $146 – $146 |
| 3 | Bcbs Mn aware/blue plus fee schedule · both | $148 | $148 | — | — | — | $148 – $148 |
| 4 | Medica managed medicaid/accessability fee schedule · both | $153 | $153 | — | — | — | $153 – $153 |
| 5 | Sanford Health Plan medicare advantage fee schedule · outpatient | $155 | $155 | — | — | — | $155 – $155 |
| 6 | UnitedHealthcare medicare advantage fee schedule · outpatient | $155 | $155 | — | — | — | $155 – $155 |
| 7 | WellCare medicare advantage fee schedule · outpatient | $155 | $155 | — | — | — | $155 – $155 |
| 8 | Ucare medicare advantage/msho fee schedule · outpatient | $157 | $157 | — | — | — | $157 – $157 |
| 9 | Bcbs Mn medicare advantage fee schedule · outpatient | $161 | $161 | — | — | — | $161 – $161 |
| 10 | Medica medicare advantage non-snp fee schedule · outpatient | $164 | $164 | — | — | — | $164 – $164 |
| 11 | Ucare pmap fee schedule · outpatient | $165 | $165 | — | — | — | $165 – $165 |
| 12 | Medica medicare advantage non-snp fee schedule · both | $166 | $166 | — | — | — | $166 – $166 |
| 13 | Bcbs Mn pmap fee schedule · both | $167 | $167 | — | — | — | $167 – $167 |
| 14 | Bcbs Mn aware federal fee schedule · outpatient | $168 | $168 | — | — | — | $168 – $168 |
| 15 | Medica msho/medicare advantage snp fee schedule · both | $170 | $170 | — | — | — | $170 – $170 |
| 16 | Bcbs Mn aware/blue plus fee schedule · outpatient | $171 | $171 | — | — | — | $171 – $171 |
| 17 | Ucare pmap fee schedule · both | $171 | $171 | — | — | — | $171 – $171 |
| 18 | Medica managed medicaid/accessability fee schedule · outpatient | $189 | $189 | — | — | — | $189 – $189 |
| 19 | Medica msho/medicare advantage snp fee schedule · outpatient | $204 | $204 | — | — | — | $204 – $204 |
| 20 | Ucare individual and family with m health fairview fee schedule · outpatient | $275 | $275 | — | — | — | $275 – $275 |
| 21 | Medica bold fee schedule · both | $289 | $289 | — | — | — | $289 – $289 |
| 22 | UnitedHealthcare commercial fee schedule · both | $294 | $294 | — | — | — | $294 – $294 |
| 23 | UnitedHealthcare core fee schedule · both | $294 | $294 | — | — | — | $294 – $294 |
| 24 | Medica vantage self insured fee schedule · both | $313 | $313 | — | — | — | $313 – $313 |
| 25 | Medica city of st. paul/essential-uplan fee schedule · both | $321 | $321 | — | — | — | $321 – $321 |
Last updated: Feb 6, 2026
See Padded orthotic brace addition for knee or ankle correction pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.